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Risk factors for monoclonal gammopathy of undetermined significance: a systematic review
Maira A Castaneda-Avila1, Christine M Ulbricht1, Mara Meyer Epstein2,3
1Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
Abstract:
Monoclonal gammopathy of undetermined significance (MGUS), precursor of multiple myeloma, is an asymptomatic plasma cell disorder that overproduces serum monoclonal protein. Older age, male sex, black race, and family history of MGUS increase the risk of MGUS, yet other risk factors are known. We systematically reviewed observational epidemiological studies that examined sociodemographic, clinical, and behavioral risk factors for the development of MGUS. The protocol for this study was registered on the PROSPERO registry for systematic reviews. We identified epidemiological studies from PubMed and Scopus. Articles were limited to those written in English and published before February 2019. Five case-control and three cohort studies were eligible for data extraction. Studies evaluating factors associated with MGUS risk are limited, with conflicting conclusions regarding risk associated with obesity. Despite the limited research, a significant elevated risk for being diagnosed with MGUS was associated with several specific prior infections, inflammatory disorders, and smoking. The sparse existing literature suggests an increased risk of MGUS associated with several risk factors related to immune function. Further research is needed to explore the potential mechanisms underlying the development of MGUS and to confirm risk factors, both modifiable and non-modifiable.
Insights
Monoclonal gammopathy of undetermined significance (MGUS) is a precursor to multiple myeloma. Research indicates infections, inflammatory disorders, and smoking may elevate MGUS risk, warranting further investigation into immune function factors.
Area of Science:
- Hematology
- Epidemiology
- Oncology
Background:
- Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic plasma cell disorder and a known precursor to multiple myeloma.
- While age, sex, race, and family history are established risk factors, other sociodemographic, clinical, and behavioral factors require further examination.
Purpose of the Study:
- To systematically review observational epidemiological studies on risk factors for MGUS development.
- To identify sociodemographic, clinical, and behavioral factors associated with an increased risk of MGUS.
Main Methods:
- Systematic review of observational epidemiological studies identified through PubMed and Scopus.
- Inclusion criteria limited studies to English language and publication before February 2019.
- Data extraction from five case-control and three cohort studies.
Main Results:
- Limited studies exist, with conflicting findings on obesity as a risk factor.
- Significant elevated risk for MGUS diagnosis was associated with specific prior infections, inflammatory disorders, and smoking.
- Existing literature suggests increased MGUS risk linked to immune function-related factors.
Conclusions:
- Research on MGUS risk factors is sparse and conclusions are often conflicting.
- Prior infections, inflammatory conditions, and smoking are associated with increased MGUS risk.
- Further research is essential to elucidate mechanisms and confirm both modifiable and non-modifiable risk factors for MGUS.
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